Thursday, April 13, 2017

---#CitizenGuineaPigs, #PureNorthS’EnergyFoundation------The troubling role of the Health ministry in this first boondoggle includes the fact that they provided the cash despite the information provided that indicated that there was no discernible justification for such alternative therapy being practiced on vulnerable seniors (7,300 of them) and the fact that there was no reasonable reason to eliminate the requirement for an ethical review of the proposed health care work being done on our tab. As well no one seems to have noted that if there were adverse results from this unproductive sponsorship of a quack science project, the GOA would be held responsible and it would be the public who would be paying for the dumb decisions of the bureaucrats and politicians involved.

If this was a story by Kafka there would possibly be a whole pile of human beings as guinea pigs enrolled in a multivitamin project with possibly adverse consequences but no one would be responsible because the folks at Alberta Health simply moved the boundaries. So the folks at Pure North S'Energy Foundation would have to go through an ethical review that might possibly impede it getting the $10 million that the PCs wanted to give them-with no strings? No problem for Alberta Health. They simply move the boundaries transforming the study that required ethical review into health services which has no sort of pesky details. Then not satisfied by the reviews for the $10 million spent that indicated less than satisfactory returns on our cash the good folks at Alberta Health simply give the company MORE cash at a time when we are in debt and wishing for cash for seniors. The cash for seniors and other vulnerable folks is being disbursed through the company in the form of the dumb products it provides. So wacky. The Kafka tale is not done. The Amrhein guy apparently gave his blood to ensure that he would be tested for the treatment offered--he was participating in the program. What the heck is going on in Alberta Health?
It was bad enough with the Horne guy but now we have the Hoffman disbursing cash like Santa to companies that could jolly well fund their own quack science projects by themselves without increasing the liability to the public purse. How many more years until this junk is done with? It's taking forever to see the end in sight.

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From: Julie Ali <
Date: Thu, Apr 13, 2017 at 9:34 PM
Subject: RE: Waste of $14.2 million dollars on quack science projects by bigwigs at Alberta Health----Trussler said she questioned Amrhein about his signing of an October 2016 grant, worth $4.2 million, for a nurse-practitioner-led clinic for Pure North. She said Amrhein told her the decision was made elsewhere and he merely signed the agreement in his capacity as deputy minister, after the minister had signed off.
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psimons@edmontonjournal.com



Dear Ms. Hoffman,
I have recently read a few articles that indicate poor management of public funds by the department of Health.

I was shocked first to understand that we are paying for a private venture by a company that received funds for $10 million dollars through the generous support of the former PC government. This dubious venture in part (at least what I understand of it) claims that supplements such as vitamin D beyond what is acceptable dosage results in preventative health states that ultimately save the taxpayers money. Apparently there are fewer emergency visits. Such dumb claims made by a multimillionaire was sufficient to get him major public dollars for no good reason that I can determine while respectable science gets trashed as in the case of the recent decision by the GOA to not bother collecting any more tissues for the tumour bank.

The first infusion of $10 million to this company Pure North S'Energy Foundation-went through despite no rigorous review and no sort of decision making tree being followed that I can determine. I am surprised that the government of Alberta would permit such shoddy science to be funded and then to provide this cash so that work could be conducted on human guinea pigs without any sort of ethical review.

The troubling role of the Health ministry in this first boondoggle includes the fact that they provided the cash despite the information provided that indicated that there was no discernible justification for such alternative therapy being practiced on vulnerable seniors (7,300 of them)  and the fact that there was no reasonable reason to eliminate the requirement for an ethical review of the proposed health care work being done on our tab. As well no one seems to have noted that if there were adverse results from this unproductive sponsorship of a quack science project, the GOA would be held responsible and it would be the public who would be paying for the dumb decisions of the bureaucrats and politicians involved.

Besides the use of human subjects as guinea pigs, there is also  the rather lax release and use of medical data that I don't believe is reasonable from the AHS database for business purposes when this project was not a research project but was  classified as provision of health services. In addition, approval of the grant money was done in a rather odd fast tracked way indicating to this citizen at least-- that this money was approved despite the problems associated with this project.  

Why would the GOA also pay the money in a lump sum amount up front which is very unreasonable since this services were not yet provided and there were no results that indicated that these services should be funded in the first place much less continued? This entire first deal smacks of nepotism of the worst PC sort.  The provision of cash has all the  hallmarks of a favourite son being given major bucks for no other reason than he is a favourite son.

The first infusion of cash is mind boggling. Then, despite the change in the political party, the same poor decision making continues and there is another mind boggling infusion of cash with the approval of the Amrhein who apparently left a paper trail -despite his admonishments to the Kaminski at AHS --of no paper trail please -we're government. Why did we bother to change political parties if the incompetence and poor use of public dollars continues with the new political party? We might as well have stayed with the poorly performing PCs but I guess at least with the poorly performing NDP we only waste $4.2 million dollars instead of $10 million dollars.

So I am looking at the paper trail and it seems to indicate that the Amrhein guy  knows the folks at this company and that he is in favour of its less than scientific arguments of being a source of wellness.  This is surprising. Surely with his background in science the Amrhein guy can spot a dumb science project using human guinea pigs right away? But apparently not.  I also note the Amrhein guy was also personally involved with this company donating his blood for purposes of evaluation and such like. Surely if you are a deputy health minister you don’t go and get personally involved with companies you are approving millions of dollars for?  

Personally I find all of this money spent on Pure North to be a waste of taxpayer dollars. I also am inclined to believe that the government of Alberta wasted $10 million + $4.2 million for no other reason than to support a man who has big bucks himself.



Pure North is the private foundation of multi-millionaire Calgary philanthropist Allan Markin, the former chairman of energy giant Canadian Natural Resources Ltd. He declined repeated interview requests from CBC News.


***
As a result of the articles I have read,  I have some questions I would like answered by the ministry.


1) Why did the Ministry pay out $10 million dollars to a multimillionaire who could jolly well completely fund his crackpot ideas?  I mean if you look at what Canada Health has to say about his claims it is clear that he is not doing science but certainly some sort of nutritional supplement business with detrimental results to the vulnerable population he was experimenting on. What is going on in Alberta that we have citizens becoming human guinea pigs and no  sort of ethical oversight of these experiments?  If at least there is no moral or ethical compass left in government surely there is a legal compass that indicates a class action lawsuit is possible when the citizens find out they were used by the company and Alberta Health for no good reasons?


2) Why did the Ministry not learn from the first mistake and then hand out $4.2 million to the same business?  According to the Amrhein guy he says you signed off on this deal FIRST and then he signed off.  So why did you sign off on a deal which was clearly not in the public interest?


3) Why did Carl Amrhein who presumably has some science training not understand that he was dealing with junk science with reference to this company and wasting our money? I mean I understand you have no background in research and science so you would not know this is a big waste of money but surely the Amrhein would know?

4) Why  is Carl Amrhein still employed by us when he approved of such a major mistake?  

5) What about the conflict of interest business when Carl Amrhein signs off on a $4.2 million deal with a company that has been contacting him and encouraging him to support this dubious venture?

6) What about the ethical problems of this venture where seniors and other vulnerable folks acted as guinea pigs in a poorly controlled science project subsidized involuntarily by the taxpayers?

7) What sort of legal issues/ problems are present in this dubious set up that is ongoing? What is the liability to the public purse?

8) Why are we paying for the program still when it's a big waste of our taxpayer dollars?

9) What is the decision making tree at Alberta Health? Do the bigwigs decide on the projects based on their superior's support of such dumb projects?  Do you have any sort of oversight that prevents such poor decisions being made that cost us millions of dollars?

10) What sort of training do the decision makers at Alberta Health have in terms of science backgrounds that would even allow the provision of cash, data and ongoing support of a dumb project that is the brainchild of a man with no medical background whatsoever?

11) Who is in charge of this mess? I.e. who is responsible for this mess?

12)  When will there be an Auditor General review of the poor performance of all concerned to provide accountability for the waste of cash? We already have some transparency due to the good work of some fine journalists now what about the accountability?

I could go on. But for now I provide the links I have read and when I have done my own review I will follow up with more questions. It is simply amazing how incompetent the decision making tree is at Alberta Health. The $14.2 million dollars wasted on the multimillionaire's dumb project in supplements could have paid for extra staff and more training in the continuing care system. When will the NDP get up to speed and reverse the culture of entitlement that results in so much waste of public dollars? Albertans are suffering while folks at Alberta Health are partying on our dollars for no darn reason that I can determine other than to fulfil the unsubstantiated beliefs of a former oil magnate. This is very poor performance.

Sincerely,

Julie Ali



Alberta 'tumour bank' reducing staff and service after loss of funding


FIRST POSTED: SUNDAY, MAY 01, 2016 05:45 PM MDT | UPDATED: MONDAY, MAY 02, 2016 08:48 AM MDT
Cross Cancer Institute in EdmontonCross Cancer Institute in Edmonton. (Larry Wong photo)
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A medical research service that collects and freezes tumours removed from cancer patients is facing questions about its future after losing its main funding source.
The Alberta Cancer Research Biobank, more commonly known as the “tumour bank,” has stopped taking new samples and laid off five staff members after seeing its budget cut by more than half.
The remaining budget is being used to maintain the current collection of 1.5 million tumours and fluids, which are split between storage facilities in Edmonton and Calgary.
“The model we are going to operate on with the bank is going to be a little bit different,” said Dr. Matt Parliament, senior medical director with CancerControl Alberta. “It will be a little bit leaner and it will not continue to grow as it has in the past.”
Established in 2001, the service has been largely funded by the Alberta Cancer Foundation, which has been providing annual grants of about $2 million in recent years. Earlier this year, the foundation informed Alberta Health Services it would not be renewing the contributions, leaving the health authority to shoulder the costs.
A spokeswoman for the foundation did not provide an exact reason for the move, but said funding decisions are often based on the ability to raise philanthropic support, and an evaluation of priorities to drive improved care for patients.
Parliament said AHS decided it couldn’t replace all the funding that was lost but wanted to at least maintain access to the “incredible resource” that had already been built. He said the biobank’s samples, which are all from Alberta patients, and can last indefinitely because they are stored in liquid nitrogen at temperatures around -80 C.
Edmonton’s storage site is at the Cross Cancer Institute, while Calgary’s part of the collection will be moved shortly to the Richmond Road Treatment Centre.
“Researchers can take those samples out of the bank and do experiments to look into the inner workings of the cancer cells,” Parliament said. “They might do DNA sequencing or look at mutations of cancer, to basically broaden the knowledge of cancer.”
The repository is used by about two dozen researchers each year, who must pay fees to access the samples, he said.
Lab technicians accounted for most of the layoffs, four of which were in Edmonton and one in Calgary.
Parliament said additional job losses were planned for Calgary, but staff there managed to find other positions. He said the same may happen in Edmonton, as AHS is trying to find new jobs for the people affected.
The cuts at the biobank are somewhat ill-timed, occurring the same month Mayor Don Iveson announced ambitions to make Edmonton a bigger hub of medical research, innovation and technology.


Alberta rushed $10-million grant, eliminated ethical oversight, for unproven health program

Review found Pure North program could not prove health or economic benefits

By Jennie Russell, Charles Rusnell, CBC News Posted: Apr 04, 2017 5:00 AM MT Last Updated: Apr 04, 2017 5:00 AM MT
Alberta Health determined the alternative health program offered by the private foundation of a Calgary oilman wasn't adequately supported by science and its high doses of supplements could pose a potential health risk — but the government provided a $10-million grant anyway.
Alberta Health determined the alternative health program offered by the private foundation of a Calgary oilman wasn't adequately supported by science and its high doses of supplements could pose a potential health risk — but the government provided a $10-million grant anyway. (CBC)
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Six days before Alberta Health rushed to deliver a $10-million grant to a private alternative-health foundation, the ministry abruptly changed the grant's purpose, eliminating the need for ethics approval for what experts say was a human-subject experiment on thousands of Alberta seniors.
On Dec. 23, 2013, former Progressive Conservative health minister Fred Horne approved the funding to Pure North S'Energy Foundation to expand an unproven, alternative "wellness" program, ultimately to more than 7,300 seniors.
Horne made the decision against the advice of officials from several ministries who had determined the Pure North program was not adequately supported by scientific evidence, could not prove the incredible health and economic benefits it claimed, and could cause adverse health effects in participants. The officials also said no funding should be granted without an ethical review of the entire Pure North program.
"Current research supplied by Pure North is unpublished in peer reviewed medical journals," states an internal Alberta Justice document dated Aug. 28, 2013, less than four months before Horne granted the funding. "It is unclear if the results are clinically significant and lead to better health outcomes."
Horne did not respond to interview requests over the past several weeks.
University of Alberta political scientist Jim Lightbody, an expert in public governance, said there are "tried and true" methods for governments to independently determine whether funding a particular project is valid. That includes substantiating the benefits claimed by the organization requesting funding.
"That is why there are guidelines; that is why there is a competitive process (for funding)," Lightbody said. "And it would seem that there was an end run -  consistently - around any attempt to apply that kind of standard testing to this kind of operation."

Pure North collects health information

Pure North is the private foundation of multi-millionaire Calgary philanthropist Allan Markin, the former chairman of energy giant Canadian Natural Resources Ltd. He declined repeated interview requests from CBC News.
The foundation targets vulnerable populations such as the homeless, addicted, seniors and Indigenous people in such places as homeless shelters and on reserves. Its various health programs offer high-dose vitamins and minerals, lifestyle counselling and, in some cases, treatments to remove heavy metals from participants' blood and mercury-amalgam fillings from their teeth.
None of its alternative treatments are supported by conclusive science.
Pure North collects detailed medical information from its participants, including blood samples, and has built a "mega-database" to which university researchers have been provided access.
The foundation, however, insists it is not conducting research but instead gathers data to gauge the efficacy of its program. Its spokesperson, Stephen Carter, told CBC News the information provided to researchers is simply a "secondary" use of that data.
Carter also claims Pure North has many studies that prove the effectiveness of its program. He said 50,000 people have participated in the program without any safety issues.
Tim Caulfield, director of research for the University of Alberta's Health Law Institute, said if the government had consulted him on whether the Pure North program should be funded, "I would clearly say no.
"I don't think there is any evidence to support, for example, the high doses of vitamin D," he said. "Yes, there is interesting research going on. But there is no evidence to support the funding of this kind of level for this kind of service."

Irregularities in funding agreement process

Thousands of pages of internal government documents obtained by CBC News reveal numerous irregularities in how Alberta Health came to provide the funding to Pure North, including that:
  • For more than a year, the Pure North funding request had been classified, and internally analyzed as a research project. Documents show the research project was supported by then-premier Alison Redford. But the documents contain no explanation for why the ministry abruptly changed the grant's purpose on Dec. 17, six days before Horne signed the funding agreement.
  • The change from health research project to an expansion of Pure North's existing seniors program meant Pure North was not required to obtain independent approval from a research ethics board for its activities.
  • The final grant agreement did not contain any detailed project budget, clear description of the program Pure North would offer to seniors, or specific targets the foundation had to meet.
  • The $10-million grant was inexplicably rushed. "We need to execute it this week," Health chief delivery officer Glenn Monteith told colleagues in a Dec. 17, 2013 email entitled "Urgent meeting." A colleague, Lorraine McKay, issued the directive in an email. "10 million (dollar) grant Pure North - right now. To foundation's efforts to support seniors' initiatives. High level - one year, one time," she said, adding, "bolt in some description material" for the grant.
  • A senior Health official personally walked the ministry's payment request to ATB Financial in downtown Edmonton on Dec. 24, the day after the grant agreement was signed.  
  • Pure North's funding was not "gated" or paid in instalments, based on demonstrable performance measures. Instead, Alberta Health gave Pure North the entire $10 million up front, which some academic researchers say is extraordinary.
  • The documents contain no discussion of the potential liability for the Alberta government should Pure North's program cause any of the adverse health effects senior officials had previously identified. In a review of the Pure North program a year after the program started, Alberta's chief medical officer of health warned of potential liability for the province "should things go wrong."
Pure North spokesperson Stephen Carter acknowledged the request for funding started as a research project, but the focus eventually changed to an established program targeting seniors.
"The Government of Alberta, and Alberta Health in general, isn't interested in funding research projects," Carter said. "They're interested in funding health care for Albertans. So they decided to shift the project and we agreed to shift the project to providing direct health care."
Internal documents, however, show that immediately after Pure North received the funding, Markin began seeking access directly through health minister Fred Horne to anonymized patient data from Alberta Health Services. Markin wanted access to the data so university researchers could assess the efficacy of the recently funded seniors program.
Internal documents show Pure North made repeated requests for funding to the Alberta government, which continued after the NDP assumed power in May 2015.
The program for which Pure North had received the $10-million grant ran for 15 months, ending in March 2015.
As part of the funding agreement, the foundation had to submit both a financial report and a brief progress report every three months. When Pure North submitted its final progress report in late May 2015, it asked for another $4.5 million to continue one part of the program for seniors with special health needs.

"No convincing data" to support claims

In response to the funding request, Alberta Health ordered a review of the Pure North wellness program. Two of three reviewers agreed there was no convincing data to support the claim the program would achieve the health benefits claimed by Pure North. The third reviewer thought a more rigorous review of the program would be needed to either confirm or contradict the foundation's claims.
Two reviewers also raised concerns about the quality of evidence supplied by Pure North. They said much of it was self-reported by participants, there was no evidence any benefits were specifically attributable to the Pure North program, and changes to measures of chronic disease didn't appear large enough to be clinically relevant.
"Placebo effects are very common with nutritional supplements and there are concerns that the program may be overstating the benefits of the supplements, enhancing the placebo effect," a summary of the two reviewers' findings states.
Carter insisted the program was a success. As proof, he cited a study conducted by Herbert Emery of the University of Calgary's School of Public Policy.
Emery's study found participants who stayed in the program for two years significantly reduced their visits to emergency rooms and hospitals, saving the system $276 for each Pure North participant.
But all three independent reviewers found a serious problem with how Pure North calculated savings for the health-care system. They said Pure North told the ministry each client cost the program between $1,280 and $2,300 a year.
When Pure North performed its cost-saving calculations, it "used a cost of $500 per year per client.
"It is unclear how the program could be offered at a dramatically lower cost while maintaining the same results," the reviewers' summary states.
"Based on the absolute reduction in hospital visits (2 per cent), we would need to treat 50 people to avoid a single hospital visit," the review's summary states. "Even using the $500 figure, the program cost would be $25,000 in order to save $1,107 in acute care costs."
Two reviewers said the documentation supplied by Pure North didn't support further investment by the government. The third reviewer couldn't make an evidence-based recommendation but felt a more formal review was warranted "due to the pressing need for community-based health promotion in the province."
NDP Health Minister Sarah Hoffman turned down Pure North's request for further funding of the seniors program based on advice from ministry officials.
In an interview, Hoffman said she had no knowledge of how Pure North came to get the funding from the former Conservative government.
If you have any information about this story, or for another potential story, please contact us in confidence at cbcinvestigates@cbc.ca



CBC INVESTIGATES

Alberta Health deputy minister's relationship with private foundation 'not professional': expert

Carl Amrhein endorsed and participated in Pure North alternative health program

By Jennie Russell, Charles Rusnell, CBC News Posted: Apr 13, 2017 7:00 AM MT Last Updated: Apr 13, 2017 7:00 AM MT
Deputy health minister Carl Amrhein participated in Pure North S’Energy Foundation’s alternative health program.
Deputy health minister Carl Amrhein participated in Pure North S’Energy Foundation’s alternative health program. (CBC)
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Photo of Charles Rusnell, Jennie Russell
Charles Rusnell, Jennie Russell
Investigative reporters
Charles Rusnell and Jennie Russell are reporters with CBC Investigates, the award-winning investigative unit of CBC Edmonton. Their journalism in the public interest is widely credited with forcing accountability, transparency and democratic change in Alberta. Send tips in confidence to cbcinvestigates@cbc.ca. @charlesrusnell @jennierussell_

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Alberta Health deputy minister Carl Amrhein personally endorsed, and participated in, an unproven alternative health program offered by a private foundation that recently received a multimillion-dollar grant that he signed on behalf of the ministry.
A CBC News investigation has uncovered a years-long relationship between Amrhein, the Pure North S'Energy Foundation of Calgary, and its founder Allan Markin that an expert in public governance said was clearly unprofessional.
"The essence of a professional relationship with a client, or with an organization that is seeking money, is called arm's length," University of Alberta political scientist Jim Lightbody said.
"You have a job and you are not, as a public servant — particularly if you are a senior public servant — at the beck and call of some private interest, no matter how well financed," he added.
Jim Lightbody
University of Alberta political scientist Jim Lightbody said the close relationship between health deputy minister Carl Amrhein and Pure North was “not professional.” (CBC)
"This is not a professional relationship," Lightbody said after reviewing internal Alberta Health and University of Alberta documents obtained by CBC News through freedom of information.

Disclosed Pure North participation

Amrhein declined interview requests. But the health ministry issued a statement that simply said: "Amrhein's involvement with Pure North was fully disclosed to the ethics commissioner when he became deputy minister. All records indicate that subsequent decisions regarding funding for Pure North followed the advice of external and departmental experts."
Ethics commissioner Marguerite Trussler told CBC News that when Amrhein became deputy minister in August 2015, he disclosed to her office that he was a participant in Pure North's alternative health program.
But she refused to say whether Amrhein had disclosed anything more about his relationship with the health foundation, saying she was bound by provincial legislation and only had permission from Amrhein to reveal he had disclosed his participation in Pure North's health program.
Trussler said she questioned Amrhein about his signing of an October 2016 grant, worth $4.2 million, for a nurse-practitioner-led clinic for Pure North. She said Amrhein told her the decision was made elsewhere and he merely signed the agreement in his capacity as deputy minister, after the minister had signed off.
The ethics commissioner said her questioning of Amrhein took place "recently." But she could not say whether it was after CBC News published stories on Pure North last week.
Health Minister Sarah Hoffman's press secretary, Tim Wilson, did not respond to questions from CBC News about whether Amrhein had disclosed his prior relationship with Pure North to the minister, and to his senior staff.
Sarah Hoffman
Health Minister Sarah Hoffman refused to say whether deputy minister Carl Amrhein had disclosed his previous relationship with Pure North to her. (CBC)

Deputy minister arranged to have blood drawn

The internal government and university documents detail a close relationship between Amrhein, Markin and Pure North dating back years to when Amrhein was provost of the university, to which Markin was a major donor.
Most disturbing for Lightbody were documents that show Amrhein, while deputy health minister, and his wife planned to become participants in the Pure North program.
Emails from early January 2016 show Markin wanted a personal meeting with Amrhein that would require Amrhein to drive to the Edmonton airport late on a Sunday afternoon.
"The smaller the group the better I think," Amrhein wrote in an email to Wendy Paramchuk, Pure North's executive director, from his official government account. "I assume that the discussion will be high level since I do not manage operating details."  
Amrhein also told Paramchuk he planned to bring his wife to the meeting, hopefully so they could have their blood taken. Pure North collects blood from its participants to determine individual treatment plans, often involving high doses of supplements such as vitamin D.
"We will set up to have our nurse practitioner there to take both your and [your wife's] blood and do a medical intake," Paramchuk replied in an email written the day before the Jan. 3 meeting.
"If possible, if you could both fast for eight hours that would be ideal," Paramchuk continued. "If not, that is okay; we will still take your blood."
"Dear Wendy, okay, I copied [my wife] on this note," Amrhein replied.

Reference letter for Pure North

Pure North is a privately run, non-profit foundation established by Markin that claims it can prevent chronic disease and improve health through its alternative treatments, which include high doses of vitamin D and other supplements and the removal of heavy metals from the body.  
The foundation focuses its work on vulnerable populations such as seniors, the homeless and drug users, and has for years sought a financial partnership with the provincial government. It also funds nutrition and health research at universities.
With donations of more than $20 million, Markin is one of the University of Alberta's biggest donors. Before Amrhein became deputy minister, he was provost at the University of Alberta and documents show he met personally with Markin several times dating back to 2011.
'The essence of a professional relationship with a client, or with an organization that is seeking money, is called arm's length ... this is not a professional relationship.'- Jim Lightbody, political scientist, University of Alberta
In July 2014, as provost, Amrhein wrote a letter of support for Pure North and Markin that lauded the research data — and financial support — Pure North had given his university's academics.
"It has been a privilege to be able to work with Mr. Allan Markin and the Pure North S'Energy Foundation and we look forward to seeing all the program outcomes analyzed in a rigorous manner that meets the highest scientific standards," Amrhein wrote. "If I can supply any further information regarding this outstanding supporter of research, please do not hesitate to contact me directly."
Internal Alberta Health documents show Pure North used Amrhein's letter in September 2014, and again in December 2014, to bolster funding requests to the Progressive Conservative government.

Foundation seeks government funding

In November 2014, Amrhein left the university to become official administrator of Alberta Health Services (AHS). Five days before he left AHS to become deputy minister of health in August 2015, Paramchuk sent an email to two faculty members in the University of Alberta's School of Public Health.
"We have asked the [health] ministry to financially support our program to be delivered to the vulnerable population of Alberta," she wrote in the email.
"This suggestion came from Carl Amrhein," Paramchuk said, and asked the faculty members to review information that Pure North intended to submit to the ministry in support of its funding request.
Duff Conacher of Democracy Watch, a non-partisan watchdog organization, said he believes Amrhein's reference letter in support of Pure North belies bias and creates a potential conflict of interest.
Conacher
Duff Conacher of Democracy Watch said health deputy minister Carl Amrhein should not have been involved in any decisions related to Pure North. (CBC)
"He stated it; that he favours the foundation," Conacher said. "It adds to that conflict of interest if he is actually taking part and receiving the services from the foundation.
"And combined together, I think it clearly crosses the line in both the [provincial Conflicts of Interest] Act and the Code [of conduct for ministers' staff], and he should not have been taking part in any decisions that affected the foundation, that the government was making," he said.
Pure North had previously received public funding. As CBC News reported earlier this month, Alberta Health gave Pure North a $10-million grant in December 2013 to expand its existing seniors program — against the advice of senior ministry officials who said the foundation's alternative treatments were not adequately supported by science and could pose a health risk to participants.
A subsequent review by three independent experts found Pure North couldn't prove its program produced any of the health or economic benefits it claimed.
CBC News also reported that senior Alberta Health Services officials were informed in July 2013 of a serious potential health risk that provincial dietitians believed could have been caused by Pure North's lax distribution of high-dose supplements at the Calgary Drop-In Centre.
When the NDP assumed power in 2015, Health Minister Sarah Hoffman refused, based on advice from her officials, to extend funding to Pure North for its seniors program beyond the $10 million provided by the previous government.

Multi-million-dollar grant agreement

But internal documents show Pure North then began requesting changes to health-care policy that would directly benefit the foundation and further its aims. On several occasions, Markin and Paramchuk communicated directly with Amrhein.
Amrhein directed his staff to research several policy changes requested by Pure North, including making vitamin D an insured drug and allowing nurse practitioners to bill for primary care services provided by the foundation.
None of the policy changes were implemented, although the documents reveal senior ministry officials expended significant resources researching them and dealing directly with Markin. Conacher said Amrhein should not have been involved in any decisions related to Pure North, given his previous support of the foundation.
'He stated it; that he favours the foundation ... it adds to that conflict of interest if he is actually taking part and receiving the services from the foundation.'- Duff Conacher, Democracy Watch
In a Jan. 15, 2016 email, Markin expresses frustration to Amrhein that progress on several policy changes requested by Pure North had been "stymied" by ministry officials.
"As an ally for preventive care, I am calling on you to intervene immediately and send direction to your officials to urgently pursue solutions that will deliver preventive care for our province's most vulnerable citizens," Markin told Amrhein.
Pure North did, however, eventually receive support from the NDP government. In October 2016, Alberta Health finalized a grant agreement — signed by Amrhein — with Pure North to provide the $4.2 million over several years for the nurse-practitioner-led, primary-care clinic in Calgary.
Earlier this month, Hoffman told CBC News she was unaware of any previous public-health safety concerns related to Pure North. She also said the clinic's funding would be jeopardized if it was found to offer any alternative health treatments.
If you have any information about this story, or for another story, please contact us in confidence at cbcinvestigates@cbc.ca.





Dietitians of Canada / Les diététistes du Canada TEL: 905.689.3864 480 University Avenue, Suite 604 FAX: 416.596.0603 Toronto, Ontario, Canada M5G 1V2 EMAIL: marsha.sharp@dietitians.ca www. dietitians.ca | www. dietetistes.ca February 19, 2015 The Honourable Rona Ambrose, PC, MP Minister of Health, House of Commons Ottawa, ON K1A 0A6 By e-mail: minister-ministre@hc-sc.gc.ca Dear Minister Ambrose: We at Dietitians of Canadai write to you to express our concern about recent public advocacy related to vitamin D. Paid advertisements by Pure North S’Energy Foundation, placed in newspapers across the country, have challenged definitions of sufficient serum vitamin D levels and have recommended daily vitamin D supplementation at doses of 6000–9000IU/day (more for individuals who are overweight or obese). These dosages are many times greater than amounts currently recommended by the Institute of Medicine (IOM) and Health Canada and exceed the current Tolerable Upper Intake Levelii of 4000IU/d for children over age 9 and adults. These recommendations are based on observational evidence – low-level evidence obtained from simple comparisons, not well-designed randomized controlled trials. What medical ethics board would approve a population-wide research protocol that sought to administer supplements far in excess of national reference intakes and upper limits, based on nothing more than observational evidence? In 2013, Dietitians of Canada raised concerns about scientific and economic interpretations of the Pure North initiative directly with the University of Calgary following its published commendation for public policyiii. We received no response. The recent public nature of Pure North’s generously-funded advocacy program and the publication of yet another public policy paperiv, however well-intended, now prompt us to be more public with our questions and concerns, recognizing the health of Canadians could be put at risk. As you know, the discourse of science continues to evolve, and population health recommendations must consider both the potential benefits for the majority and risks for vulnerable segments of the population. We understand your officials in Health Canada, together with the IOM, are analyzing evidence available from newer, more rigorous studies, as well as re-examining parameters leading to the IOM recommendations in 2010. Even in the face of intense advocacy from groups such as Pure North, we urge Health Canada to continue this due diligence, carefully considering the level of evidence, and ask that this analysis be made publicly available when completed. We recognize science is emerging with respect to the role(s) that vitamin D may play from pregnancy to old age, for health promotion, illness prevention and improvements in ill health. Nevertheless, we do not believe there is consistent, strong evidence at this point in time to recommend a broad clinical intervention for “health optimization”, using megadose supplements to change dietary intake targets for the Canadian population. Earlier claims and assertions based on observational evidence about other nutrients, e.g., vitamin E, betacarotene, and folic acid, are now recognized to have serious limitations in spite of what at first appeared to be convincing evidence. When randomized controlled scientific experiments were conducted with these vitamins as megadose supplements, there was no statistically significant evidence of substantial health benefit beyond prevention of vitamin deficiency and no additional roles were identified for these nutrients beyond healthy metabolism and body functions, as already established. Indeed, both vitamin E and beta-carotene supplements were found to increase ill health and risks: vitamin E increased mortalityv , and beta-carotene increased cancer rates among smokersvi. Vitamin D is the current ‘darling’ of the nutrition world. Hundreds of published peer reviewed papers report associations between apparently sub-normal/sub-optimal serum levels of 25-hydroxy-vitamin D and poor health conditions, including cardiovascular diseases, serum lipid concentrations, inflammation, glucose metabolism disorders, weight gain, infectious diseases, multiple sclerosis, mood disorders, declining cognitive function, impaired physical functioning, and all-cause mortalityvii. In contrast, results of randomized controlled trials are just beginning to be published, and these reports are not consistently supporting the early findings from observational studies. Some studies suggest that blood levels of 25- hydroxy-vitamin D decrease as a marker of illness, rather than poor vitamin D status, thereby providing no data to support changes in vitamin D requirements as currently understood. Sensational and often contradictory reporting in public media can add to consumer confusion. A recent vitamin D study provides content analysis of 294 newspaper articles published between 2009-2014 – findings included enthusiastic linkage of vitamin D to a host of health conditions, with recommendations to supplement, underplaying the lack of conclusive evidence and omitting or downplaying any risks associated with supplementation. The researchers concluded there is a need for “good, independent and reliable sources of health information that present a more nuanced and contextualised picture of the relevant science”viii. We believe it is important that Health Canada proceed with caution before any recommendation is made for substantial vitamin D supplementation and/or pervasive vitamin D fortification of foods/beverages intended for the Canadian population. Any changes to public health policy must be based on a better understanding of potential roles for vitamin D, as well as potential risks from high vitamin D intakes. Health Canada’s guidance must pay heed to both the potential risks and benefits, lest our food supply itself becomes a population health experiment the next generation may regret. New science on vitamin D is currently being published at a rapid rate. New data on vitamin D levels of Canadians from the Canadian Health Measures Survey (CHMS) will no doubt also inform decisions. We urge you to continue to support the scientific process within Health Canada. The ‘cherry-picked’ evidence championed by some, including Pure North, must not be used to support premature recommendations for substantial vitamin D supplementation and/or vitamin D fortification of foods and beverages. Furthermore, given the aggressive and public nature of this debate, we recommend issuing a public advisory to protect the public and provide interim guidance for confused consumers. Thank you for your consideration of our concerns and suggestions. If you have any questions please contact Pat Vanderkooy (pat.vanderkooy@dietitians.ca) or Jayne Thirsk (jayne.thirsk@dietitians.ca), who would be pleased to provide additional information and response. Sincerely, Marsha Sharp, CEO Dietitians of Canada cc. Samuel Godefroy, Director General, Food Directorate, Health Canada William Yan, Director, Bureau of Nutritional Sciences, Food Directorate, Health Canada Hasan Hutchinson, Director General, Office of Nutrition Policy and Promotion, Health Canada i Dietitians of Canada (DC) is the professional association representing 6000 dietitians (regulated health professionals) across the country. DC promotes evidence-based best practice in dietetics, to advance the profession’s unique body of knowledge of food and nutrition and supports members in their diverse roles in health and wellness. ii A Tolerable Upper Intake Level (UL) is the highest level of continuing daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals in the life-stage group for which it has been designed. ULs are based on evaluations conducted using the Dietary Reference Intakes: A Risk Assessment Model for Establishing Upper Intake Levels for Nutrients adopted in 1998 for the DRI process by the Institute of Medicine. The risk assessment model was designed specifically to address the potential for adverse effects from overconsumption of nutrients.” (From Health Canada website: The DRI values – definitions. Available from: http://www.hc-sc.gc.ca/fnan/nutrition/reference/dri_ques-ques_anref-eng.php#a5a iii Emery JCH, et al. The Fiscal, Social and Economic Dividends of Feeling Better and Living Longer. SPP Research Papers, Vol 6, Issue 20, June 2013, University of Calgary. http://www.policyschool.ucalgary.ca iv Dutton DJ, Emery JCH, et al. Bending the Medicare Cost Curve in 12 Months or Less: How Preventative Health Care Can Yield Significant Near-Term Savings for Acute Care in Alberta. SPP Research Papers, Vol 8, Issue 2, January 2015, University of Calgary. http://policyschool.ucalgary.ca/ v Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2012 Mar 14;3:CD007176. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22419320 vi Cortés-Jofré M, Rueda JR, Corsini-Muñoz G, Fonseca-Cortés C, Caraballoso M, Bonfill Cosp X. Drugs for preventing lung cancer in healthy people. Cochrane Database Syst Rev. 2012 Oct 17;10:CD002141. doi: 10.1002/14651858.CD002141.pub2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12804424 vii Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014 Jan;2(1):76-89. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24622671 viii Caulfield T, Clark MI, McCormack JP, Rachul C, Field CJ. Representations of the health value of vitamin D supplementation in newspapers: media content analysis. BMJ Open. 2014 Dec 31;4(12):e006395. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281532/





Archived - Statement from Health Canada on Vitamin D

Archived Content

Information identified as archived is provided for reference, research or recordkeeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please contact us to request a format other than those available.
Over the past few months, Pure North S'Energy Foundation (Pure North) has placed advertisements in the Globe and Mail alleging that Health Canada's Dietary Reference Intakes (DRIs) for vitamin D are incorrect.
Health Canada and the Institute of Medicine (IOM) reviewed and analyzed the information provided by Pure North. We concluded that there is no statistical error in the calculation of our vitamin D standards, and that the authors of the research misinterpreted the meaning of the recommended intake level in the 2011 IOM report.
Health Canada has confidence in the IOM's rigorous process and ability to provide the department with solid scientific advice. We will continue to use the DRI standards as the basis for our nutrition policies and programs. There are no health benefits associated with vitamin D intakes above the level of the Recommended Dietary Allowance (RDA), and we advise Canadians to keep their total nutrient intake below the Tolerable Upper Intake Level (UL) to avoid possible adverse effects.
Health Canada continues to recommend that Canadians follow the advice in Canada's Food Guide. The Food Guide recommends that all Canadians over the age of two, including pregnant and lactating women, consume 500mL (two cups) of milk or fortified soy beverages every day to contribute to adequate vitamin D intake. In addition, Health Canada recommends that people over the age of 50 take a daily vitamin D supplement of 400 IU.






Funding announcement falls short: Nurse Practitioner Association of Alberta

The province announced $10 million in funding on Friday to hire several health care professionals over the next three years

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Eric Lavoie, president of the Nurse Practitioner Association of Alberta, says a new funding announcement from the province is a step in the right direction, but doesn’t go far enough.
CONTRIBUTED
Eric Lavoie, president of the Nurse Practitioner Association of Alberta, says a new funding announcement from the province is a step in the right direction, but doesn’t go far enough.
By: Elizabeth Cameron For Metro Published on Mon Feb 27 2017
The president of the Nurse Practitioner Association of Alberta (NPAA) said a new funding project from the province promising to hire more of the highly-skilled health professionals doesn’t go far enough.
“It’s a step in the right direction, but not the right scale,” Eric Lavoie said.
He was at the Alex Community Health Centre in Calgary on Friday, when the province announced a $10 million, three-year health project that will enable four facilities in Calgary and Edmonton to hire several additional care professionals, including nurse practitioners (NP’s).
NP’s are qualified to diagnose and treat most health concerns, including ordering tests, prescribing medications and performing various procedures.
“The NPAA’s standpoint is that this is a positive step in the right direction, but it’s nowhere near the systemic change that will see Albertans benefit from NP care,” said Lavoie.
He has been calling for a sustainable, province-wide funding model for NP’s for more than a year.
“We would like to see the development of a sustainable funding model for NP to integrate into primary care throughout the province,” Lavoie said.
“Although (this project) is great … they’re only adding about five new NP positions – it falls short of what is required to innovate and remain sustainable.”
Grants have been allocated to The Alex Community Health Centre, Pure North S’Energy, and the Calgary Urban Project Society (CUPS) in Calgary. The Boyle McCauley Health Centre in Edmonton also received funding.
An expert advisory group, led by the Institute for Health Economics, will guide and evaluate the new projects. The results will help form new policies, according to Brandy Payne, Alberta’s associate minister of health.
“We will take what we learn from these projects to make decisions that will protect and improve the primary health care Albertans depend on,” Payne said at the announcement.




ALBERTA OFFICE OF THE INFORMATION AND PRIVACY COMMISSIONER ORDER F2016-59 December 8, 2016 UNIVERSITY OF CALGARY Case File Numbers 004107 and 004108


RECOVERY;EVERY VOICE MATTERS
FRESH START RECOVERY CENTRE
ANNUAL REPORT 2015
WHAT’S YOUR
MESSAGE?

Pure North is passionate about supporting those in recovery who make the commitment to themselves, their families and their communities. The Pure North program provides the body with the nutrients it needs at all levels and for people in recovery there is an even greater need because of multiple deficiencies. For the men at Fresh Start Recovery Centre, they know all too well that there are no quick fixes or shortcuts to real recovery; the first year of recovery from addiction is primarily a physical journey. Since 2011, Pure North S’Energy Foundation has been operating a clinic in the lower level of Fresh Start for the residents, alumni and staff. Twice a month the nurses, doctors, support staff, clinicians and naturopaths arrive at Fresh Start to help clients with their health concerns, perform testing, administer supplements and vitamins, and determine where the body is at now to make a plan of action to support each person they see to reaching optimal health. In 2015, Pure North saw 150 unique clients engaged in their program through Fresh Start and this amounts to over $100,000 worth of support that is provided to Fresh Start free-of-charge. As well, Pure North saw 56 Fresh Start clients for dental-related issues amounting to over $65,000 worth of support provided to Fresh Start. Like the multi vitamin packs offered in the dining room or the nutrient-packed smoothie prepared every morning by our in-house chef, the clients participate in their own health revitalization. Pure North provides each participant with a personalized program to help them optimize nutrition and reduce the likelihood of illness in the future. Overall, the partnership between Fresh Start Recovery Centre and Pure North S’Energy Foundation has been instrumental in aiding these men through all phases of their recovery. ~ Allan Markin, Founder and Chief Accountability Officer, Pure North S’Energy Foundation

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